The meaning of life is to find your gift. The purpose of
life is to give it away. William Shakespeare
Blood Test Could Predict Rheumatoid Arthritis
Petra Maria Longewag writing in the Maine News reported new research suggests, a
simple blood test may soon help doctors identify a debilitating form of
arthritis, much before the emergence of any symptoms, helping stop the disease
from progressing further. According to the study, elevated inflammatory proteins
called cytokines levels in the blood warn of impending rheumatoid arthritis
The new study reports elevated levels of certain markers of inflammation i.
e. cytokines and related factors can be detected in the blood stream, long
before the development of rheumatoid
arthritis or symptoms of the disease
Solbritt Rantapää-Dahlqvist, MD., one of the researchers in a news release said
these findings offer an opportunity for predicting the risk of developing RA,
and perhaps, even preventing disease progression.
Research Suggests TZDs And Sulfonylureas Both Increase Risk For
Fractures Compared With Metformin.
Miriam writing in Medscape reported that research suggests that “the oral
diabetes drug classes of thiazolidinediones (TZDs) and sulfonylureas both boost
the risk for fractures compared with metformin.” This research “confirms
previous findings of increased fracture risk with TZDs but is the first to
compare multiple classes of glucose-lowering agents and the first to suggest a
possible increased fracture risk for sulfonylureas, Sandhya Mehta, PhD...told
the American Diabetes Association (ADA) 2014 Scientific Sessions.”
Mortality reduced in RA patients
who maintained methotrexate therapy
Reported in Helio, an article published in Clinical and experimental
rheumatology, researchers in Germany analyzed data on 271 patients with
rheumatoid arthritis (RA; disease duration, 8.5 years) who had started
methotrexate (MTX) treatment between 1980 and 1987. Modified American College of
Rheumatology 20 (ACR20) response was used to measure response to MTX treatment 1
year after baseline. Follow-up data were available for 250 patients (mean age,
57.5 years; 78.4% women) up to 18 years.
Of those patients, 66% had a ≥20% response rate at 1 year (responders), 20%
were considered nonresponders, and 14% had stopped MTX treatment because of lack
of efficacy or adverse events including nausea, vomiting or stomatitis.
Sixty-one percent of patients maintained MTX treatment at 10 years after
Responders had a 1.6 mortality ratio compared with a 3.2 ratio among
nonresponders after 18
RA Patients Show Relationship Between Inflammation And Carotid Artery
Nancy Walsh writing in Medpage Today reported, “Among patients with rheumatoid
arthritis, rapid progression of thickening of the wall of the carotid arteries
was associated with systemic inflammation and the presence of multiple
cardiovascular risk factors,” according to a study published online in Annals of
the Rheumatic Diseases. Such a link had been suggested in other studies, so a
new study of 487 patients was conducted using “high-resolution carotid
ultrasounds at baseline and 3 years later.” Overall, “factors associated with
progression of carotid artery disease included baseline carotid artery
thickening, ESR of 55 mg/hour or higher, and the presence of four or more CV
Men at higher risk after joint replacement
Patrice Wendling writing in Rheumatology News reported that a Canadian
from the University of Toronto indicated that men were more likely to suffer
from complications after joint replacement than women. Complications included
heart attack, infection, and revision surgery. The increased risk was
particularly severe following total knee replacement. Findings were presented at
the World Congress on Osteoarthritis.
OA Walking Disability Increases Cardiovascular Risk
Patrice Wendling writing in Rheumatology News reported that walking disability
is an independent predictor of death from cardiovascular events/. Also, total
joint replacement reduced that risk by 40% according to a Canadian study from
the University of Toronto and presented at the World Congress on Osteoarthritis.
Study: Rheumatologists Give Inconsistent Smoking Cession Advice
Nicola Garrett writing for Rheumatology Update reported a study found that “two
out of three rheumatologist give smoking
cessation advice to their patients,”
with physicians who smoked less likely to offer the advice. However, “brief
advice given by a doctor could increase quit rates by 66%, and when the
intervention is more intensive the estimated effect was 88%.” Meanwhile, “only 1
in 5 rheumatology departments had either a specific protocol or written advice
for smoking cessation.” The authors called for recognizing tobacco dependence is
a disease often requiring repeated interventions and “clear, strong and
personalized advice” for patients.
Gender May Impact Perception Of Pain Following Surgery
Agata Blaszczak-Boxe writing for CBS News reports that a new study presented at
this year’s Euroanaesthesia meeting in Stockholm has determined that men “were
27 percent more likely to report higher pain ratings after a major surgery such
as a knee replacement, while women were 34 percent more likely to report
experiencing more pain after
procedures that the researchers labeled as minor,
such as biopsies.” Researchers interviewed 10,200 patients from the University
Hospitals of the Ruhr University of Bochum, Germany, following an operation,
over the course of more than four years. Although the researchers are uncertain
of the cause for these differences, “they speculate that a lot may depend on the
kind of surgery a person is undergoing,” with procedures such as cancer-related
biopsies taking “a particularly serious emotional toll on women.”
Medical Marijuana May Be Effective Treatment For Autoimmune Diseases
Thomas Carannante writing in Science World Report revealed that “researchers at
the University of South Carolina” have “conducted a study” in mice “that
analyzed the effects of THC in marijuana on patients with autoimmune diseases
because the drug has previously shown to have an immunomodulatory activity.” In
this study's case, the researchers found
that the application of marijuana has
the ability to suppress an immune response to treat autoimmune diseases, such as
arthritis, lupus, colitis, multiple sclerosis, and others. The new findings are
published in the Journal of Biological Chemistry.
Elderly Women Who Take Bisphosphonates Long-Term May Have Increased
Risk Of Atypical Femur Shaft Fractures
Nicola Garrett writing in Rheumatology Update reported that research published
in Osteoporosis International indicated that “elderly women who take
bisphosphonates long-term have an increased risk of atypical femur shaft
fractures...but the overall benefits of treatment still outweigh the risks.”
Researchers “found that each additional year of bisphosphonate treatment showed
a progressive increase in subtrochanteric/femoral shaft fractures.”
Ring in the holiday... with
Don’t let your joint pain affect your holiday plans!
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Crunchy high-fiber apricot and apple bars
Nutrition for Life
- 1 cup dried apricots
- 2 apples
- 4floz (120ml) apple juice
- 1 cup margarine
- 1/2 cup soft brown sugar
- 1 2/3 cups whole-wheat flour
- 1 1/4 cups oats
- Preheat the oven to 350°F (180°C). Lightly oil a shallow baking pan
measuring 13” by 9” (32 by 22cm).
- Chop the apricots, and peel, core,
and finely chop the apples. Place in
a pan with the apple juice and simmer for 10 minutes.
- Let the mixture cool slightly, then blend in a food processor until
- In a bowl, beat together the margarine and sugar until creamy, then fold
in the flour and oats.
- Spread half of the flour and oat mixture over the baking pan. Spoon the
apricot and apple mixture on top and spread evenly. Cover with the remaining
flour mixture and press down lightly.
- Bake for 30 minutes until light golden. Cut into 16 bars while in the
tray, and let cool before removing. Store in an airtight container.
Remarkable Uses for Oven Cleaner
Seven unbelievable uses for oven cleaner.
from Extraordinary Uses for Ordinary Things
Put the style back in your curling iron – Is your curling
iron buried under a layer of caked-on styling gel or conditioner? Before the
next time you use it, spray on a light coating of oven cleaner. Let it sit for
one hour, then wipe it off with a damp rag, and dry with a clean cloth. Warning:
Do not use
iron until it is thoroughly dry.
Wipe away bathtub ring – Got a stubborn stain or ring around
your white porcelain tub that refuses to come clean? Call out the big guns by
spraying it with oven cleaner. Let it sit for a few hours, then give it a
thorough rinsing. Warning: Do not apply oven cleaner to colored porcelain tubs;
it could cause fading. And be careful not to get the oven cleaner on your shower
curtain; it can ruin both plastic and fabric.
Clean grimy tile grout lines – Ready for an all-out attack
on grout grunge? First, make sure you have plenty of ventilation — it’s a good
idea to use your exhaust fan to suck air out of a small bathroom. Put on your
rubber gloves and spray oven cleaner into the grout lines. Wipe the cleaner off
with a sponge within five seconds. Rinse thoroughly with water to reveal
sparkling grout lines.
Clean ovenproof glass cookware – You’ve tried
scrub those baked-on stains off your glass cookware. Now try this: Put on rubber
gloves and cover the cookware with oven cleaner. Then place the cookware in a
heavy-duty garbage bag, close it tightly with twist ties, and leave overnight.
Open the bag outdoors, keeping your face away from the dangerous fumes. Use
rubber gloves to remove and wash the cookware.
Clean a cast-iron pot – If you need to clean and re-season
that encrusted secondhand cast-iron skillet you found at a yard sale, start by
giving it a good spraying with oven cleaner and placing it in a sealed plastic
bag overnight. (This keeps the cleaner working by preventing it from drying.)
The next day, remove the pot and scrub it with a stiff wire brush. Then, wash it
thoroughly with soap and water, rinse well, and immediately dry it with a couple
of clean, dry cloths. Note: This technique eliminates built-up gunk and grease,
but not rust. For that,
you’ll need to use vinegar. Don’t leave it on too long,
though. Prolonged exposure to vinegar can damage your cast-iron utensil.
Remove stains from concrete – Get those unsightly grease,
oil, and transmission fluid stains off your concrete driveway or garage floor.
Spray them with oven cleaner. Let it settle for 5-10 minutes, then scrub with a
stiff brush and rinse it off with your garden hose at its highest pressure.
Severe stains may require a second application.
Strip paint or varnish – For an easy way to remove paint or
varnish from wooden or metal furniture, try using a can of oven cleaner; it
costs less than commercial paint strippers and is easier to apply (that is, if
you spray rather than brush it on). After applying, scrub off the old paint with
a wire brush. Neutralize the stripped surface by coating it with vinegar, and
then wash it off with clean water. Allow the wood or metal to thoroughly
before repainting. Don’t use oven cleaner to strip antiques or expensive
furnishings; it can darken the wood or discolor the metal.
Watch the sugar!
Healthy Living-Summer 2014
The USDA recommends that people consume no more than 10 teaspoons of added
sugar (160 calories) per day in a 2,000 calorie per day diet. Since it can be
tricky to determine just how much added sugar you are consuming, keep the
following in mind the next time you go food shopping:
- Be aware that sugar goes by many names, including syrup, corn sweetener,
molasses and anything that ends in “ose” –such as maltose, sucrose and
- Ingredients in packaged foods are shown in descending order by weight;
the higher up a form of sugar is listed, the more the product contains.
- You can also check a product’s Nutrition Facts Panel to figure out the
number of grams of sugar per serving; since each gram of sugar contains 4
calories, multiplying the number of grams by 4 will give you the number of
calories from sugar in the item.
Wei's World, November 2014
(This is excerpted from my blog post on Medscape Rheumatology)
It's no secret that people wager a lot of money on sports outcomes and base
their decision making on what "the line" is.
My wife and I recently attended a wedding in Utah. It was the first Mormon
wedding we had ever been to and it was beautiful, performed against the backdrop
of the Zion National Park.
If you’ve never been there, it is an amazing place with breathtaking scenery
against a backdrop of colorful mesas. It truly is, as one patient remarked to
me, a spiritual place.
We then spent a day in Las Vegas, since that was the closest
major airport, and
we had an early flight home to Washington, so staying in "Sin City" made more
sense than driving to Las Vegas from Zion at 1AM.
I knew I “wasn’t in Kansas” anymore when I got off the plane and there was a 400
pound man sitting at a slot machine at the arrival gate.
I was stunned.
If medicine is to make progress in preventative health, it will require a
As physicians, we are competing with human nature.
During our brief stay in Las Vegas, I saw more obese people at slot machines
chowing down on junk food and smoking than I could ever imagine. Not to mention
all the other excesses and assault on my senses. The flashing lights, loud
noises, cigarette smoke, and traffic all combined to cause sensory overload.
Now, I know many people like Las Vegas. I'm just not one of them. Frankly, I
found it disheartening since many of the conditions we treat
ones. And this experience brought it home to me.
This episode also illustrates why the mandated school lunch program with fruits
and vegetables is a dismal failure. How do you change human nature?
And where do we draw "the line" on personal responsibility?
When I tell a patient they need to make adjustments in their life style and they
don’t listen and suffer a bad health outcome, I still feel culpable. Yet I know
that I can’t make them do healthier things. I can only recommend it to them.